Anne-Marie Trevelyan contributions to the Mental Capacity (Amendment) Act 2019

Tue 18th December 2018 Mental Capacity (Amendment) Bill [Lords] (Commons Chamber)
2nd reading: House of Commons
Money resolution: House of Commons
Programme motion: House of Commons
Ways and Means resolution: House of Commons
3 interactions (670 words)

Mental Capacity (Amendment) Bill [Lords]

(2nd reading: House of Commons)
(Money resolution: House of Commons)
(Programme motion: House of Commons)
(Ways and Means resolution: House of Commons)
Anne-Marie Trevelyan Excerpts
Tuesday 18th December 2018

(1 year, 9 months ago)

Commons Chamber
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Department of Health and Social Care
Sir Lindsay Hoyle Portrait Mr Deputy Speaker (Sir Lindsay Hoyle) - Hansard

I must now introduce a six-minute limit on speeches.

Anne-Marie Trevelyan Portrait Anne-Marie Trevelyan (Berwick-upon-Tweed) (Con) - Parliament Live - Hansard
18 Dec 2018, 5:55 p.m.

It is an honour to speak in this Second Reading debate on a subject of real importance to some of my most vulnerable constituents across north Northumberland. I want to focus on one cohort of those for whom the Bill is important: those in care homes.

I first became aware that the deprivation of liberty safeguard system was not fit for purpose as a new parliamentary candidate some years ago, while visiting the excellent care homes across my rural constituency—the small, family-run care homes based in sparsely populated areas that elderly constituents have made their home, some by choice, many placed there by Northumberland County Council and some whose family could no longer care for them at home.

One of the first issues raised with me on those visits—even then, when the deprivation of liberty system had just been put in place for those who were unable to consent any more—was that the system was proving burdensome and not family or vulnerable person-centric, and that our local authority had become rapidly overwhelmed by the unnecessary layers of bureaucracy, with six separate assessments clogging up the system but failing to ensure protection and reassurance.

The care home managers in my wonderful small and otherwise person-centric care homes were drowning in paperwork and new requirements but could not get the answers they needed quickly from county hall or doctors. It seemed to all those whose careers—indeed, vocations—it is to run care homes that the bureaucracy was simply adding complexity without positive value or outcomes. Much of the work was simply going over the same ground already covered by local authority officials when the decision to place vulnerable elderly constituents into the care home had been made originally.

Busy managers felt they were simply going round in circles, but they were especially concerned by the distress that the system was causing their residents—not only those to whom the deprivation of liberty assessment related, but others with greater capacity who had to watch their co-residents’ anxiety increase and were concerned that when they became that frail, all that would happen to them too.

This Bill is a welcome piece of legislation to provide important safeguarding for our most vulnerable elderly and young adults with severe learning disabilities or autism, to ensure that the system functions better and to reassure us all. Whether it is members of our family or our constituents, we need to have confidence that where restrictions are deemed necessary by the carer of a vulnerable person, the checks in place are streamlined and effective. Good Government policy delivers on its aims. The original 2005 Act failed to do that.

It is encouraging that the Bill will strengthen the protections and rights of vulnerable adults who lack mental capacity and have their liberty deprived. It will introduce a simpler process that involves families more and gives swift access to assessments, which is really important and has been a problem. It will be less burdensome on people, carers, families and local authorities, and it will allow the NHS, rather than local authorities, to make decisions about their patients, allowing a more efficient and clearly accountable process—something that many GPs have raised with me consistently over the years.

The Bill will consider restrictions of people’s liberties as part of their overall care package, which should be a self-evident truth but has not been under the historical legislation, and it will get rid of repeat assessments and authorisations when someone moves between a care home, hospital and ambulance as part of their treatment. We have few ambulances in north Northumberland, and this has been a huge burden for the paramedics who have to deal with these difficult and complex cases. There is enormous frustration, because there is a sense that people are not getting patient-centric care, which is what everybody looking after them wants to achieve. These proposals go a long way towards creating a system that can be trusted by our constituents, and I look forward to working with the Minister to ensure that the Bill reaches the statute book quickly.

Alex Cunningham Portrait Alex Cunningham (Stockton North) (Lab) - Parliament Live - Hansard
18 Dec 2018, 5:56 p.m.

First, I declare my interest as chair of the all-party group on social work. This very Bill was the subject of our most recent meeting, when we heard from those working in this sector. These are no doubt some of the most important issues we could be debating and legislating on, and judging by the attendance at the all-party group meeting, it could not be more important to the policy makers and professionals in the field. This legislation governs the rights of individuals and the people who can deprive them of one of their most basic fundamental rights—freedom.

Some of the people attending the all-party group felt the Bill had made some progress with the amendments in the House of Lords, but it is fair to say that the Bill is simply not yet good enough. I really think that the Government need to pause, think again about the implications of the plans that Ministers are putting before us today, listen to the countless charities, other organisations and professionals that work with the legislation every day and then come back with a Bill that is fit for purpose.

This cannot and must not be a basic political argument between the Government and the Opposition; it is a debate between law makers and the people, some of whom at a particular time in their life can be subject to some of the most restrictive legislation we have. It saddens me that this could be another Government measure to cut the costs of associated assessments under the current Act.

There is a wealth of briefing material, from organisations as diverse as the Law Society and the Royal College of Nursing, outlining concerns that need to be discussed and addressed through the legislation. There are serious issues with potential conflicts of interest, but I think the Minister knows that. Imagine a scenario in which a care home manager is making a decision on someone’s life but has a financial interest in making a judgment either way. The Royal College of Nursing shares my concerns on this. Care home managers may feel under pressure in their workplace, meaning that they may make decisions that are not always in the best interests of the person they are caring for. There should not be any vested interest—only an interest in the wellbeing and freedom of the person concerned. Issues have already been raised about private hospitals. A private hospital could authorise deprivation of liberty, knowing that it would benefit financially from that. I know that the vast majority of people are honest and work in the best interests of those they care for, but such judgments should be made by a genuinely independent person.

My hon. Friend the Member for Swansea West (Geraint Davies) mentioned the Royal College of Speech and Language Therapists. There is a real and genuine risk that people may be wrongly deemed to lack mental capacity because any communication needs they have are not properly recognised. Nothing short of full staff training on communication needs—for everyone in the system—would be satisfactory as a measure to ensure that people are being assessed correctly and that any additional needs are addressed.